ArticleCritical care medicine2022
Epidemiology of ICU-Onset Bloodstream Infection: Prevalence, Pathogens, and Risk Factors Among 150,948 ICU Patients at 85 U.S. Hospitals.
Article in Critical care medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 1 of them a synthesis that pooled it.
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Who cites it
48 citing papers in PubMed, 1 synthesis or guideline pooled it, 67 citations in OpenAlex.
- Antibiotic treatment for 7 days versus 14 days in patients with uncomplicated bloodstream infections: a Systematic review and meta-analysis of randomized controlled trials and trial sequential analysis.Frontiers in medicine · 2025Pooled it
- Diagnostic performance of β-(1→3)-D-glucan, twoJournal of clinical microbiology · 2026Trial
- Contemporary Trends in Candidemia: Mortality, Species, and Antifungal Resistance Across Three Periods (2017-2025) in Houston, Texas.Open forum infectious diseases · 2026Article
- Respiratory Syncytial Virus-Associated Disease in Children Receiving Intensive Care.JAMA network open · 2026Article
- Invasive Candidiasis in Critically Ill Patients: Fundamental Concepts and Future Directions.Chest · 2026Review
- Racial disparities in healthcare-associated infections: a systematic review and meta-analysis.Infection control and hospital epidemiology · 2026Article
- ICU-acquired infection in neutropenic patients.Critical care (London, England) · 2026Article
- Sulbactam-Durlobactam in the Treatment of Bloodstream Infection Due to Carbapenem-ResistantJournal of clinical medicine · 2026Review
- Minimizing hospital acquired intensive care unit infections: A focus on prevention.World journal of critical care medicine · 2026Review
- Advancing hospital-onset bacteraemia surveillance: a five-year retrospective study following the hospital-wide implementation of an automated surveillance system at a German university hospital.Antimicrobial resistance and infection control · 2026Article
- Utilization of Intensive Care Interventions in Critically Ill Patients With Candidemia Versus Bacteremia: A Multicenter Retrospective Cohort Study.Critical care medicine · 2026Article
- Systemic inflammation response index predicts short-term mortality in intensive care unit patients with bacterial bloodstream infections.BMC infectious diseases · 2026Article
- Carbapenem-resistantFrontiers in medicine · 2026Article
- The Clinical View of Sepsis-Associated AKI: How Basic Science Can Help Solve This Problem.Seminars in nephrology · 2025Review
- Antibiotic therapy for severe bacterial infections.Intensive care medicine · 2025Review
- Early prediction of bloodstream infections in ICU patients using machine learning methods based on routine laboratory parameters.BMC infectious diseases · 2025Article
- Bacterial isolates and antibiotic resistance in critically ill sepsis patients at a tertiary hospital in Ethiopia.BMC infectious diseases · 2025Article
- Proteus mirabilis in ICU Patients: Prevalence, Risk Factors, and Future Expectations of Bloodstream Infections.Cureus · 2025Article
- The global epidemiology of carbapenem-resistantJAC-antimicrobial resistance · 2025Review
- Observational
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8 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesBloodstream infections (BSIs) acquired in the ICU represent a detrimental yet potentially preventable condition. We determined the prevalence of BSI acquired in the ICU (ICU-onset BSI), pathogen profile, and associated risk factors.
designRetrospective cohort study. DATA SOURCES: Eighty-five U.S. hospitals in the Cerner Healthfacts Database. PATIENT SELECTION: Adult hospitalizations between January 2009 and December 2015 including a (≥ 3 d) ICU stay. DATA EXTRACTION AND DATA SYNTHESIS: Prevalence of ICU-onset BSI (between ICU Day 3 and ICU discharge) and associated pathogen and antibiotic resistance distributions were compared with BSI present on (ICU) admission (ICU-BSI POA ); and BSI present on ICU admission day or Day 2. Cox models identified risk factors for ICU-onset BSI among host, care setting, and treatment-related factors. Among 150,948 ICU patients, 5,600 (3.7%) had ICU-BSI POA and 1,306 (0.9%) had ICU-onset BSI. Of those with ICU-BSI POA , 4,359 (77.8%) were admitted to ICU at hospital admission day. Patients with ICU-onset BSI (vs ICU-BSI POA ) displayed higher crude mortality of 37.9% (vs 20.4%) ( p < 0.001) and longer median (interquartile range) length of stay of 13 days (8-23 d) (vs 5 d [3-8 d]) ( p < 0.001) (considering all ICU stay). Compared with ICU-BSI POA , ICU-onset BSI displayed more Pseudomonas , Acinetobacter , Enterococcus, Candida , and Coagulase-negative Staphylococcus species, and more methicillin-resistant staphylococci, vancomycin-resistant enterococci, ceftriaxone-resistant Enterobacter , and carbapenem-resistant Enterobacterales and Acinetobacter species, respectively. Being younger, male, Black, Hispanic, having greater comorbidity burden, sepsis, trauma, acute pulmonary or gastrointestinal presentations, and pre-ICU exposure to antibacterial and antifungal agents was associated with greater ICU-onset BSI risk after adjusted analysis. Mixed ICUs (vs medical or surgical ICUs) and urban and small/medium rural hospitals were also associated with greater ICU-onset BSI risk. The associated risk of acquiring ICU-onset BSI manifested with any duration of mechanical ventilation and 7 days after insertion of central venous or arterial catheters.
conclusionsICU-onset BSI is a serious condition that displays a unique pathogen and resistance profile compared with ICU-BSI POA . Further scrutiny of modifiable risk factors for ICU-onset BSI may inform control strategies.
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